EP0082265B1 - Système d'attachement pour une prothèse supportée par la muqueuse - Google Patents

Système d'attachement pour une prothèse supportée par la muqueuse Download PDF

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Publication number
EP0082265B1
EP0082265B1 EP82109578A EP82109578A EP0082265B1 EP 0082265 B1 EP0082265 B1 EP 0082265B1 EP 82109578 A EP82109578 A EP 82109578A EP 82109578 A EP82109578 A EP 82109578A EP 0082265 B1 EP0082265 B1 EP 0082265B1
Authority
EP
European Patent Office
Prior art keywords
fastening system
prosthesis
spherical head
receiving
spherical
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired
Application number
EP82109578A
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German (de)
English (en)
Other versions
EP0082265A1 (fr
Inventor
Egon Dr. Brinkmann
Manfred Putenat
Erhard Dr. Dörre
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Feldmuehle AG
Original Assignee
Feldmuehle AG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Feldmuehle AG filed Critical Feldmuehle AG
Priority to AT82109578T priority Critical patent/ATE13970T1/de
Publication of EP0082265A1 publication Critical patent/EP0082265A1/fr
Application granted granted Critical
Publication of EP0082265B1 publication Critical patent/EP0082265B1/fr
Expired legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0048—Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/0075—Implant heads specially designed for receiving an upper structure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00—Dental prostheses; Making same
    • A61C13/225—Fastening prostheses in the mouth
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00—Dental prostheses; Making same
    • A61C13/225—Fastening prostheses in the mouth
    • A61C13/265—Sliding or snap attachments
    • A61C13/2656—Snap attachments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0093—Features of implants not otherwise provided for
    • A61C8/0095—Total denture implant
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0048—Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/0078—Connecting the upper structure to the implant, e.g. bridging bars with platform switching, i.e. platform between implant and abutment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K6/00—Preparations for dentistry
    • A61K6/80—Preparations for artificial teeth, for filling teeth or for capping teeth
    • A61K6/884—Preparations for artificial teeth, for filling teeth or for capping teeth comprising natural or synthetic resins
    • A61K6/887—Compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds

Definitions

  • the present invention relates to a fastening system for a removable, mucous membrane, worn prosthesis, consisting of two ball heads attached to implants or natural tooth roots, which exceed the volume of a hemisphere and are provided with a highly polished surface, to hold the prosthesis, from two provided for engagement with the ball heads, this adapted, and fixed in cavities of the prosthesis receiving caps made of smooth and elastic plastic material and two in the region of the opening of the receiving caps arranged adaptation rings.
  • Denture prostheses are known which are held in place by suction on the palate or are held in place on the remaining teeth by holding elements. These prostheses can be referred to as mucosa-supported prostheses. These are often unsatisfactory and come loose during food intake and when speaking. It has therefore already been proposed to attach artificial dentures to endosseous implants inserted in the alveolar ridge. This technique has already found widespread use in dentistry, but cannot be used successfully in every case, but is essentially limited to providing non-removable single tooth replacement or shortened rows of teeth with firm hold, and for this purpose is sometimes remarkable Successes used.
  • CH-A-597 843 has disclosed a fastening system for fastening a mucous membrane-supported prosthesis, in which a prosthesis in which a receiving cap made of elastic material is attached is attached to implants bearing ball heads.
  • the receiving caps enclose the ball heads almost completely, which creates a rigid fastening of the push button type.
  • the disadvantage of this proposal is that a lateral movement of the prosthesis through the rigid seat is not possible.
  • a fastening system of the type mentioned at the outset is known from US Pat. No. 4,204,321, in which the prosthesis is to be held firmly by a type of push-button technique.
  • the disadvantage here is the insufficient mobility of the denture prosthesis, so that this proposal can serve primarily for fastening an upper jaw prosthesis.
  • FR-A-12 11 044 the attachment of balls or cylinders made of rust-free non-magnetic metals or alloys to screw-shaped implants is provided.
  • the proposed cylindrical shape provides for the shape of a spherical cap at the end with which the cylinder is attached to the implant.
  • Correspondingly designed counterparts - so-called patrices - are provided for attachment to the balls or cylinders, which are welded to one another by metal strips and thereby lead to a rigid connection. This creates a removable bridge.
  • Special rod-like pieces which are attached to the counterparts pushed over the balls or cylinders, or the end plate of such a counterpart, are used to fasten the dentures.
  • a disadvantage of this system is that, due to the rigid connection, the forces occurring during chewing are transmitted directly to the ball head or to the implant.
  • Another proposal of FR-A-12 11 044 therefore provides for an elastic mass arranged in the counterparts.
  • the decisive disadvantage of this proposal is also that a lateral movement of the denture is not possible, rather a rigid connection results.
  • a fastening system described in US Pat. No. 1,101,810 also has the disadvantage that lateral movement of the prosthesis carried by the mucous membrane is not possible.
  • a spherical spring clip is embedded in the prosthesis, which engages over a solid ball fastened with a pin in a tooth root.
  • Another disadvantage of the solid ball is that the ball extends far into the oral cavity and the prosthesis therefore has a greater tendency to tip over.
  • Another disadvantage, as well as other proposals that have become known from the prior art is that it is not possible to close an opening made in the jaw with a solid ball and, for. B. end plates must be used to close a tooth root opening.
  • the object of the present invention is to eliminate the existing disadvantages and to develop a fastening system for a removable, mucous membrane-supported prosthesis, by means of which the prosthesis, in particular for total dentures of the lower jaw, is held firmly and securely against lateral forces.
  • the prosthesis should not be connected to the implants by a rigid connection; rather, the prosthesis should be able to move to a certain extent during the chewing process.
  • the invention aims to achieve an optimal hold of a mucous membrane-supported prosthesis both with little and with extreme lateral and vertical movement of the jaw.
  • Another object of the present invention is to avoid the known disadvantages that result from the use of metal parts in the oral cavity.
  • the invention also sees its task in creating a system which also ensures that a prosthesis is held securely even when it has to be attached to diverging implant posts.
  • the invention provides a fastening system for a removable, mucous membrane-supported prosthesis, which consists of two spherical heads, attached to implants or natural tooth roots, which exceed the volume of a hemisphere and are provided with a highly polished surface, for holding the prosthesis, two for engaging with the prosthesis Ball heads provided, this adapted and fixed in cavities of the prosthesis receiving caps made of smooth and elastic plastic material and two in the area of the opening of the receiving caps arranged adaptation rings and is characterized in that the receiving caps rest against the ball heads only in the area of their equators and that Adaptation rings are arranged between the walls of the cavities and the receiving caps and consist of a plastic material that is more elastic than the material of the receiving caps.
  • the excellent hold of the prosthesis during vertical and lateral movements of the jaw results from the formation of the adaptation rings from a plastic material of higher elasticity than that of the receiving caps.
  • the adaptation rings arranged in the area of the openings of the receiving caps between the walls of the cavities for the receiving caps and the receiving caps enclose the receiving caps and bring them into close contact with the ball heads.
  • the adaption rings bring about a pressure acting in the radial direction on the receiving caps and thereby cause the receiving caps to bear tightly during their up and down movement on the ball heads, without the up and down movement of the receiving caps or the prosthesis being impaired in any way becomes.
  • the adaption rings also cause the receiving caps to fit tightly when subjected to lateral loads.
  • the present invention has thus created a fastening system in which a denture prosthesis held with the aid of implants can follow the chewing movement of a lower jaw, which ends in a rotational movement, without, in particular in the case of implants used in a divergent manner, incorrect loads and thus loosening of the implants.
  • fastening system according to the invention makes it possible to compensate for the resilience of the mucous membrane, since the prosthesis, in contrast to the previously known fastening systems, does not permanently press on the mucous membrane.
  • the present invention also makes it possible to dispense with web connections between the individual implant posts, which were often used when additional fixation of the denture prosthesis was desired.
  • the disadvantage of this web construction was that it is a one-sided load due to its rigid bond exerted certain leverage on neighboring implant posts and could loosen them.
  • the invention also makes it possible to compensate for a further disadvantage which has hitherto often occurred when a plurality of implants or their implant posts projecting beyond the alveolar ridge served as a fastening device for a removable denture prosthesis.
  • This disadvantage was that in the rarest of cases it was possible to align the implants so precisely that the forces occurring during chewing were evenly transmitted to the individual implants.
  • the fastening system according to the invention there is no longer any danger, even if the two implants, which are provided for receiving the spherical holding device, are inserted in a diverging direction.
  • the partial rotation of the prosthesis on the ball heads has a balancing effect. It also enables the ball heads to be placed on implants on natural teeth, e.g. B. to be attached to individual lower canines. So far, there were great problems when these teeth were in a diverging direction and with great difficulty an exact adjustment of the structure to be used had to be made.
  • the fastening system according to the invention is characterized in that the ball heads are designed so that their volume is between 55 and 90%, very particularly preferably between 65 and 85% of the full ball volume.
  • This type of design ensures that the part protruding into the oral cavity is lower than in the case of a solid ball, in order to avoid parts that undercut.
  • This design of the ball head also enables a better closure compared to an opening created in the jaw. On the other hand, with such a design of the ball head, there is always a sufficiently large surface area for engagement with the receiving cap.
  • the ball heads are made from densely sintered aluminum oxide with a purity of at least 97% by weight, since this material is bioinert and there is no risk of tartar formation.
  • Aluminum oxide is also a preferred material for producing the ball heads because it has a high wear resistance and, in conjunction with a receiving cap made of plastic, forms an excellent friction pairing for the purpose according to the invention.
  • the wear properties are reduced to a minimum and, on the other hand, there is also a particularly good adhesion between the ball heads and the denture prosthesis inserted receiving caps reached.
  • the receiving caps are made of polyvinyl chloride, while the adapter rings are made of polyethylene vinyl acetate.
  • This combination of materials ensures in a particularly advantageous manner that the receiving caps are in contact with the ball heads in the region of their equators due to the more elastic material of the adaptation rings and thus ensures good adhesion between the ball head and the receiving caps fastened in the denture prosthesis. This ensures in a particularly suitable manner that the prosthesis cannot stand out from a spherical head under normal horizontal and vertical loading.
  • a pin on the ball head which is provided with retention aids which, for. B. have the shape of waves, grooves, notches or undercuts.
  • retention aids which, for. B. have the shape of waves, grooves, notches or undercuts.
  • This type of retention aid ensures that, in a further preferred embodiment, the pin is also made of non-sintered aluminum oxide, that the pin or the ball head is firmly seated with the newly formed bone tissue.
  • the placeholders correspond approximately to the ball heads to be used later and are screwed into openings that are located in the head parts of the implants that protrude above the jaw.
  • the placeholders differ in their outer contours from the ball heads insofar as their dimensions are increased by the wall thickness of the receiving cap and the adaptation ring.
  • This placeholder has the function of keeping the space in the prosthesis that will later be needed for the insertion of the rotating cap and the adaptation ring.
  • This design of the placeholder ensures that openings in the lower region, where the adaptation rings are attached, are kept free in the prosthesis, the dimensions of which correspond exactly to the adaptation rings.
  • the placeholder inserted in the implant After an impression has been made using the placeholder inserted in the implant, it is removed from the implant and the opening in the implant is sealed until the ball head is inserted.
  • the placeholder removed from the implants is inserted into the impression model and a prosthesis is produced in a known manner after the production of a positive model.
  • the seals are removed and the two ball heads made of densely sintered aluminum oxide are inserted. This is done by screwing the pin-shaped lugs, which carry the ball head on one end and have a thread on their other end. After the ball heads are fixed on the implants, the prosthesis, which has now been made with the help of the impression, is placed on the ball heads. In this are the already firmly glued-in receiving caps and the adapter rings surrounding the receiving caps.
  • Figure 1b shows a partial view of the fastening system according to the invention, shown using the example of a lower jaw prosthesis.
  • the entire system consists of a lower jaw prosthesis 3 for total dentures and two ball heads 1 provided for fastening the lower jaw prosthesis 3, only one of which is shown in FIG. 1b.
  • An artificial tooth 6 is attached to the lower jaw prosthesis 3.
  • a receiving cap 8 made of polyvinyl chloride, which is fastened there with a cold-polymerizable plastic 30 and abuts the ball head 1 in the area of its equator M.
  • an adaptation ring 12 made of polyethylene vinyl acetate between the wall 10 of the cavity 7 and the wall 11 of the receiving cap 8 which - as will be shown later in FIG. 6 - when the position of the mandibular prosthesis 3 changes for an exact fit
  • Receiving cap 8 ensures and consequently always constant friction between the ball head 1 and the receiving cap 8 causes.
  • the receiving cap 8 is designed such that it only rests on the ball head 1 in its equatorial region, while a cavity 13 remains free in its upper region. If the load is uneven, the ball head 1 can penetrate into this area.
  • the receiving cap 8 and the adaptation ring 12 close with their lower edges 23 and 24 flush with each other.
  • the adaptation ring 12 is formed in Fig. 1 b so that the ratio of its height h to the radius r of the ball head 1 is 1.5: 2.5.
  • a ball head 1 is shown, which is attached with its pin-shaped extension 2, at the lower end 4 of which there is a thread 5, to a screw-shaped implant 14 made of densely sintered aluminum oxide, which has a thread 16 on its outside. Screw-in tools can be non-positively attached to ball head 1.
  • the implant 14 has a groove 15 for the attachment of the epithelial cuff.
  • Fig. 4 shows a spherical head 1, which is anchored with its pin 28 in a natural tooth root 17.
  • the pin 28 is cylindrical and fastened in the recess 27 of the ball head 1 by cement, not shown.
  • the tooth is first pulled in a manner known per se and the tooth root is shortened by the dimension A.
  • the socket is deepened by dimension B and the pin 28 is adapted to the tooth root 17 or the recessed socket. This is done by cutting the pin 28 at its end to be connected to the ball head 1.
  • the pin 28 is glued by gluing with cement in the natural tooth root 17.
  • FIG. 5a and 5b show two implants 19 and 20 which are introduced in a divergent manner in a lower jaw 18.
  • the lower jaw prosthesis 3 is shown lifted off the receiving caps 8 in FIG.
  • the figures show that the full functionality of the dental prosthesis system is ensured even in the case of implants 19 and 20 which are introduced in a divergent manner.
  • FIG. 5b shows on the left how, in the case of an assembled dental prosthesis system, ball head 1 and receiving caps 8 compensate for implants inserted at an angle.
  • Fig. 6 shows the function of the fastening system according to the invention with one-sided loading. Since a cavity 13 is formed in the receiving cap 8, the mandibular prosthesis 3 can be pressed deeper into the ball head 1 with its receiving cap 8 in the event of heavy unilateral loading. At the same time, the cavity 13 'increases due to the lifting force P' (-) occurring there, as shown in the right part of FIG. 6.
  • the adaptation rings 12 encompass the equators M on both sides and bring the receiving cap 8 'into tight contact, so that lifting off from the ball head 1' is connected and the lower jaw prosthesis 3 does not lose its secure fit.

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  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Dental Prosthetics (AREA)

Claims (14)

1. Système de fixation pour une prothèse amovible (3) supportée par la muqueuse, constitué par deux têtes sphériques (1) destinées à maintenir la prothèse (3), fixées sur des implants (14, 19) ou sur des racines naturelles (17) des dents, dépassant le volume d'une hémisphère et munies d'une surface polie miroir par deux calottes réceptrices (8) en matériau synthétique lisse et élastique, prévues pour venir en contact avec les têtes sphériques (1), adaptées à celles-ci et fixées dans des évidements (7) de la prothèse (3) et par deux bagues d'adaptation (12) placées dans la zone de l'ouverture (9) des calottes réceptrices (8), caractérisé par le fait que les calottes réceptrices (8) ne sont appliquées sur les têtes sphériques (1) que dans la zone de leurs équateurs (M) et que les bagues d'adaptation (12) sont disposées entre les parois (10) des évidements (7) et les calottes réceptrices (8) et sont réalisées en un matériau synthétique qui est plus élastique que le matériau des calottes réceptrices (8).
2. Système de fixation selon la revendication 1, caractérisé par le fait que chaque tête sphérique (1) est conçue de façon que son volume représente entre 55 % et 90 % du volume de la sphère entière.
3. Système de fixation selon l'une des revendications 1 et 2, caractérisé par le fait que la bague d'adaptation (12) est conçue de façon que le rapport entre sa hauteur (h) et le diamètre (r) de la tête sphérique (1) se situe entre 1 : 2,5 et 2 : 2,5.
4. Système de fixation selon l'une des revendications 1 à 3, caractérisé par le fait que la calotte réceptrice (8) est fixée sur la paroi (10) de l'évidement (7) au moyen d'un adhésif (3a) polymérisant à froid de façon qu'au moins la zone (22) prévue pour l'insertion de la bague d'adaptation (12) reste exempte d'adhésif.
5. Système de fixation selon l'une des revendications 1 à 4, caractérisé par le fait que l'arête inférieure (23) de la calotte réceptrice (8) est dans l'alignement de l'arête inférieure (24) de la bague d'adaptation (12).
6. Système de fixation selon l'une des revendications 1 à 5, caractérisé par le fait que la paroi (10) de l'évidement (7) dépasse des arêtes inférieures (23) et (24), situées dans l'alignement l'une de l'autre, de la calotte réceptrice (8) et de la bague d'adaptation (12) sur une distance L qui représente 1/5 à 3/5 du diamètre (r) de la tête sphérique (1).
7. Système de fixation selon l'une des revendications 1 à 6, caractérisé par le fait que la tête sphérique (1) est réalisée en oxyde d'aluminium fritté à densité maximale d'une pureté d'au moins 97 % en poids.
8. Système de fixation selon l'une des revendications 1 à 7, caractérisé par le fait que la surface de la tête sphérique (1) présente une rugosité moyenne arithmétique Ra < 0,2 wm.
9. Système de fixation selon l'une des revendications 1 à 8, caractérisé par le fait que la calotte réceptrice (8) est réalisée en chlorure de polyvi- nyle.
10. Système de fixation selon l'une des revendications 1 à 9, caractérisé par le fait que la bague d'adaptation (12) est réalisée en poly(éthy- lène/acétate de vinyle).
11. Système de fixation selon l'une des revendications 1 à 10, caractérisé par le fait que la tête sphérique (1) comporte une cheville (28) ou un appendice (2) en forme de cheville en oxyde d'aluminium fritté.
12. Système de fixation selon l'une des revendications 1 à 11, caractérisé par le fait que la tête sphérique (1) comporte un appendice (2) en forme de cheville qui se termine en cône au niveau de son extrémité (4) opposée à la tête sphérique (1).
13. Système de fixation selon l'une des revendications 1 à 11, caractérisé par le fait que la tête sphérique (1) comporte une cheville cylindrique prévue pour la fixation de la tête sphérique (1).
14. Système de fixation selon l'une des revendications 1 à 13, caractérisé par le fait que la tête sphérique (1) est placée sur un implant en forme de cheville présentant une forme cylindrique.
EP82109578A 1981-11-14 1982-10-16 Système d'attachement pour une prothèse supportée par la muqueuse Expired EP0082265B1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AT82109578T ATE13970T1 (de) 1981-11-14 1982-10-16 Befestigungssystem fuer eine schleimhautgetragene prothese.

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
DE3145260 1981-11-14
DE3145260 1981-11-14
DE3237174 1982-10-07
DE3237174A DE3237174C2 (de) 1981-11-14 1982-10-07 Befestigungssystem für eine schleimhautgetragene Prothese

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Publication Number Publication Date
EP0082265A1 EP0082265A1 (fr) 1983-06-29
EP0082265B1 true EP0082265B1 (fr) 1985-06-26

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EP (1) EP0082265B1 (fr)
DE (1) DE3237174C2 (fr)

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EP2636386A1 (fr) * 2012-03-08 2013-09-11 Titus Fischler Dispositifs et procédé de liaison d'une construction prothétique dentaire avec un os de la mâchoire
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JP6006880B2 (ja) * 2013-08-30 2016-10-12 株式会社ジーシー 有床義歯用アタッチメント
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US9931181B2 (en) 2014-07-22 2018-04-03 Zest Ip Holdings, Llc Fixed hybrid dental attachment assembly and methods of use
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Publication number Publication date
DE3237174A1 (de) 1983-05-26
DE3237174C2 (de) 1984-04-12
US4518357A (en) 1985-05-21
EP0082265A1 (fr) 1983-06-29

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